Comprehensive Weight Control Center, Division of Endocrinology, Diabetes, & Metabolism, Weill Cornell Medicine, New York, New York.
Institute of Human Nutrition, Columbia University, New York, New York.
Diabetes Obes Metab. 2019 Feb;21(2):377-381. doi: 10.1111/dom.13503. Epub 2018 Sep 10.
Data suggest that nutrient order during a meal significantly impacts postprandial glucose and insulin excursions in type 2 diabetes, while its effects in prediabetes have not been reported. Fifteen participants with prediabetes consumed the same meal on 3 days in random order: carbohydrate first, followed 10 minutes later by protein and vegetables (CF); protein and vegetables first, followed 10 minutes later by carbohydrate (PVF); or vegetables first followed by protein and carbohydrate (VF). Blood was sampled for glucose and insulin measurements at 0, 30, 60, 90, 120, 150 and 180 minutes. Incremental glucose peaks were similarly attenuated by >40% in the PVF and VF meal conditions compared with CF. The incremental area under the curve for glucose was 38.8% lower following the PVF meal order, compared with CF, and postprandial insulin excursions were significantly lower in the VF meal condition compared with CF. The CF meal pattern showed marked glycaemic variability whereas glucose levels were stable in the PVF and VF meal conditions. Food order presents a novel, simple behavioural strategy to reduce glycaemic excursions in prediabetes.
数据表明，在用餐时的营养顺序会显著影响 2 型糖尿病患者的餐后血糖和胰岛素波动，而其在糖尿病前期的影响尚未有报道。15 名糖尿病前期患者在 3 天内随机摄入相同的餐食：碳水化合物先摄入，10 分钟后再摄入蛋白质和蔬菜（CF）；蛋白质和蔬菜先摄入，10 分钟后再摄入碳水化合物（PVF）；或者蔬菜先摄入，然后再摄入蛋白质和碳水化合物（VF）。在 0、30、60、90、120、150 和 180 分钟时抽取血液样本以测量血糖和胰岛素。与 CF 相比，PVF 和 VF 餐条件下的葡萄糖增量峰值分别降低了>40%。与 CF 相比，PVF 餐序后葡萄糖的曲线下增量面积降低了 38.8%，VF 餐条件下的餐后胰岛素波动明显低于 CF。CF 餐模式显示出明显的血糖变异性，而 PVF 和 VF 餐条件下的血糖水平则保持稳定。食物顺序提供了一种新颖的、简单的行为策略，可降低糖尿病前期的血糖波动。
